This proposed project will explore the challenges and difficulties that arose for two local public health agencies (Nassau and Westchester Counties) in preparing for Hurricane Sandy and after the storm hit the New York City region. The study's goals are to: (1) conduct a case study of how Hurricane Sandy affected these two organizations and use those as tools to elucidate how complex organizations function during times of extreme duress; (2) determine how public health workers can improve upon their disaster response and recovery strategies, particularly when working on new disaster-related job tasks; and (3) identify and deliver new remedial trainings in various modalities. The project is a collaboration of the National Center for Disaster Preparedness (NCDP), a unit of Columbia University's Earth Institute and the two subject health departments, each of which will appoint an assistant/deputy-commissioner level staff member as a Co-Investigator. Other senior NCDP researchers also will be co-investigators. Over the 2-year term of this project, the investigators will (a) Analyze the communications among the health departments and other response organizations during Hurricane Sandy, as recorded in the Crisis Management Information Systems utilized by the Nassau and Westchester County Emergency Operations Centers, in order to inform development of the structured guides for interviews and focus groups; (b) Interview 10 senior leadership staff in each health department who participated in making critical decisions in preparation for and during Sandy; (c) Conduct focus groups at each agency involving at least 30 line staff in order to (along with the interviews elicit information on any gaps in communication, coordination, preparation, logistics, staff availability, competencies, and leadership that came into play during the Sandy preparation and response; (d) Analyze the transcripts of the interviews and focus groups to identify barriers and obstacles that need to be addressed in order to improve these (and possibly other) health departments' ongoing Sandy recovery efforts; (e) Develop and offer two customized face-to-face trainings for each health department in order to provide hands-on practice and support in relation to the identified barriers; (f) Develop (in collaboration with NACCHO) four Columbia-hosted distance learning offerings based upon the preceding analysis and face-to-face training experiences; and (g) Evaluate all of the above training offerings to document learning outcomes and address whether learners have used what they've learned to enhance their functional role. Each health department Co-Investigator will obtain transcripts of the county's Crisis Management Information System for the NCDP researchers, serve as liaison with the respective department for organizing key informant interviews and focus groups, and develop proposals for NCDP-provided face-to-face and online training for departmental staff.